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International Journal of Computer Assisted Radiology and Surgery

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02.07.2019 | Original Article

Normative ranges of nasal airflow variables in healthy adults

verfasst von: Azadeh A. T. Borojeni, Guilherme J. M. Garcia, Masoud Gh. Moghaddam, Dennis O. Frank-Ito, Julia S. Kimbell, Purushottam W. Laud, Lisa J. Koenig, John S. Rhee

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 1/2020

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Abstract

Purpose

Virtual surgery planning based on computational fluid dynamics (CFD) simulations of nasal airflow has the potential to improve surgical outcomes for patients with nasal airway obstruction (NAO). Virtual surgery planning requires normative ranges of airflow variables, but few studies to date have quantified inter-individual variability of nasal airflow among healthy subjects. This study reports CFD simulations of nasal airflow in 47 healthy adults.

Methods

Anatomically accurate three-dimensional nasal models were reconstructed from cone beam computed tomography scans and used for steady-state inspiratory airflow simulations with a bilateral flowrate of 250 ml/s. Normal subjective sensation of nasal patency was confirmed using the nasal obstruction symptom evaluation and visual analog scale. Healthy ranges for several CFD variables known to correlate with subjective nasal patency were computed, including unilateral airflow, nasal resistance, airspace minimal cross-sectional area (mCSA), heat flux (HF), and surface area stimulated by mucosal cooling (defined as the area where HF > 50 W/m²). The normative ranges were targeted to contain 95% of the healthy population and computed using a nonparametric method based on order statistics.

Results

A wide range of inter-individual variability in nasal airflow was observed among healthy subjects. Unilateral airflow varied from 60 to 191 ml/s, airflow partitioning ranged from 23.8 to 76.2%, and unilateral mCSA varied from 0.24 to 1.21 cm². These ranges are in good agreement with rhinomanometry and acoustic rhinometry data from the literature. A key innovation of this study are the normative ranges of flow variables associated with mucosal cooling, which recent research suggests is the primary physiological mechanism of nasal airflow sensation. Unilateral HF ranged from 94 to 281 W/m², while the surface area stimulated by cooling ranged from 27.4 to 64.3 cm².

Conclusions

These normative ranges may serve as targets in future virtual surgery planning for patients with NAO.

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Titel: Normative ranges of nasal airflow variables in healthy adults
verfasst von: Azadeh A. T. Borojeni
Guilherme J. M. Garcia
Masoud Gh. Moghaddam
Dennis O. Frank-Ito
Julia S. Kimbell
Purushottam W. Laud
Lisa J. Koenig
John S. Rhee
Publikationsdatum: 02.07.2019
Verlag: Springer International Publishing
Erschienen in: International Journal of Computer Assisted Radiology and Surgery / Ausgabe 1/2020
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-019-02023-y

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Abstract

Purpose

Methods

Results

Conclusions

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